[Unusual location of an intrauterine contraceptive device].
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The use of an intrauterine device (IUD) is associated with the presence of actinomyces in the female genital tract. Since IUD use is currently so prevalent, IUD-related pelvic inflammatory disease occasionally spreads to the rest of the abdomen. Two patients with abdominal actinomycosis in association with an IUD illustrate the problem; we review the general problem.
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A case of actinomycosis of the uterine tube occuring in a 29-year-old clerk is reported. The disease became manifest clinically a month after the introduction of IUD. In spite of intensive antiinflammatory therapy the disease was in progress and cachexia developed. The case was cured only after radical surgical intervention and antibiotic treatment.
Curved rods were found in 108 (21.6%) of 500 women consecutively attending a genito-urinary medical clinic. A positive association was elicited with the wearing of an intra-uterine contraceptive device (p less than 0.001), intercourse with a casual or multiple sexual partners within the preceding 3 months (p less than 0.001) and concurrent chlamydial infection of the uterine cervix (p less than 0.025). There was no apparent relationship with contact with non-candidal balanitis, but an increased rate (31.3%) was noted in contacts of non-gonococcal urethritis indicating a need for further research into a possible aetiological role.
An unusual case occurred of Lippes-Loop-associated pelvic abscess, characterized by a relatively mild clinical course and an unusual localization in the pelvis. This case emphasizes the importance of considering the association between intrauterine devices and pelvic abscess.
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A less common complication of intra-uterine device contraception is the lost string. Since the intra-uterine devices are more used the problem of the search for lost string intra-uterine devices has increased. An intra-uterine device forceps with a diameter of 2.5 mm. is presented. The instrument can easily be used in office practice. Removal of the device under general anaesthesia after dilation of the cervix with a large instrument can best be avoided.
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A case of probable cervical perforation and extra-peritoneal migration of a Copper-T device into the space of Retzius is hereby reported. The mechanism of this exceptional kind of translocation, its outcome and the management of the patient are discussed.
This study compares the complication rate of intrauterine contraceptive devices (IUD) with other contraceptive measures in a residency practice. The study population included 220 randomly selected women who had IUDs inserted by residents over a five-year period. One hundred similarly selected women started on birth control pills (BCP) were used as a control group. Of the IUD patients, 8.6 percent developed pelvic inflammatory disease vs 2 percent of the BCP patients. The incidence of gonorrhea was not significantly different between the two groups: 8.2 percent for the IUD groups vs 7 percent for the BCP group. Discontinuation of IUDs for reasons other than desiring pregnancy was significantly higher than discontinuation of BCPs: 41 percent vs 12 percent. Of the total IUD insertions, there were 21 expulsions (10 percent) and one uterine perforation (0.4 percent). Five pregnancies occurred in the IUD group, yielding a pregnancy rate of 1.7 per 100 women-years. There was a four percent rate of gynecologic hospitalizations in the IUD group as contrasted with one percent rate in BCP group. IUD use in the family practice setting under study is associated with comparatively poor long-term acceptance and a relatively high rate of complications.
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